Amanda Leigh Knobloch, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015042059 Issued in MO

Practice address

3601 LL Rd
Fults, IL 62244-1231

Phone

(618) 558-2497

NPI assigned

Dec 3, 2015

Last updated

Dec 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Leigh Pittman Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1396110276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 LL RD",
            "city": "FULTS",
            "state": "IL",
            "postal_code": "622441231",
            "telephone_number": "618-558-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 LL RD",
            "city": "FULTS",
            "state": "IL",
            "postal_code": "622441231",
            "telephone_number": "618-558-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLOCH",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015042059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PITTMAN",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Leigh Schultheis, RN

• Family Nurse Practitioner in Fults, IL
• Providers in Fults, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.